I am a plastic surgeon in Little Rock, AR. I used to "suture for a living", I continue "to live to sew". These days most of my sewing is piecing quilts. I love the patterns and interplay of the fabric color. I would like to explore writing about medical/surgical topics as well as sewing/quilting topics. I will do my best to make sure both are represented accurately as I share with both colleagues and the general public.

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Monday, November 24, 2008

Just now getting to writing up this article. I think it is a really nice approach to oversized lips and a good procedure to add to one’s skills. The article is The “Bikini” Lip Reduction: An Approach to Oversized Lips by Drs Fanous, Brousseau, and Yoskovitch. The full reference is given below. It is a simple, but elegant description of a technique for lip reduction.

Sir: ………. The reduction of very large lips is not a new procedure but remains a relatively unused one and has received little attention in the literature. The following presents a modified method for lip reduction referred to as the “bikini” reduction, consisting of excising a “bikini top” (two cups and a middle strap) from the upper lip, and a “bikini bottom” (a triangle) from the lower lip. This technique is unique in that it focuses not only on lip reduction but also on labial contouring and volume balance. ……………..

The patient is asked to close the lips gently. A marker is used to place a dot in the midline between both upper and lower lips at the actual dry/wet junction (Fig. 1, center, points a and a=). The patient is then asked to open the lips slightly, as the surgeon manipulates the lips with his or her fingers by rotating them inward, attempting to make them appear smaller. The patient then closes the lips. This is repeated until the size of the showing vermilion is adequately reduced, ensuring the lower lip remains roughly 40 to 50 percent more voluminous than the upper one.

Then, another dot is made in the midline on the newly created dry/wet interface (Fig. 1, center, points b and b=). The patient then opens the lips, revealing four central dots (a, a=, b, and b=).

The bikini design is now implemented (Fig. 1, center). The bikini top is marked by drawing the central strap as two parallel lines between a and b for a distance of approximately 1 cm, then diverging to form two oval cups bilaterally. The cups’ anteroposterior dimension (c to d) should be approximately double that of a to b and should end in a tapered manner a few millimeters before the commissures. The bikini bottom is drawn as a triangle (e to b= to f), with points e and f stopping a few millimeters from the commissures……..

I hope you will look up the article and read the entire work. For more information on lip reduction, also, check the other references and the post I did on lip reduction back in January.

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